Kağan ÜÇOK, Hakkı GÖKBEL, Mehdi YEKSAN, Mehmet KARA, Süleyman TÜRK, Lütfi ŞİMŞEK

Son Dönem Kronik Böbrek Yetmezliği Hastalarında Solunum Fonksiyon Testleri

Bu çalışmanın amacı son dönem kronik böbrek yetmezliği hastalarında solunum fonksiyonlarını saptamaktır. Otuziki son dönem böbrek yetmezliği hastasında (21 erkek, 11 kadın) solunum fonksiyonları tayin edildi. Hastalar en az 6 aydır haftada 2-3 kez hemodiyalize giriyorlardı, hiçbirinin bilinen bir akciğer veya göğüs duvarı hastalığı yoktu. Test sonuçları Crapo ve arkadaşları tarafından geliştirilen formüllerden hesaplanan tahmini değerlerin yüzdesi olarak ifade edildi. Özellikle DLCO, PEF, FEF%25-75 ve FEVİ değerleri düşük bulunmuştur. DLCO’daki azalma muhtemelen renal anemiye bağlıdır. FEVİ, PEF ve FEF°/o25-75’deki azalma ise anemiye ve genel zayıf lık haline bağlı solunum kaslarının güçsüzlüğünün sonucu olabilir.

Anahtar Kelimeler:

Hemodiyaliz, Son dönem böbrek yetmezliği, Solunum fonksiyonları

Pulmonary Function Tests in Patients with End-stage Renal Failure

The study aimed at investigating pulmonary functions in patients with end-stage renal failure. Pulmonary function tests (PFT) were evaluated on thirty-tuuo patients with end-stage renal failure (21 male, 11 female). Patients had been receiving hemodialysis 2-3 times in a week at least for 6 months. None was known to have lung or chest wall disease. PFT results were expressed as percentage of predicted values which were calculated from the formulas developed by Crapo and colleagues. Particularly DLCO, flow rates (PEF, FEF25-75) and FEVİ values were low. Decrease in DLCO values was probably due to renal anemia. Decrease in flow rates and FEVİ values may be result of respiratory muscle ıveakness due to anemia and general impairment.

Keywords:

Haemodialysis, End-stage renal failure, Pulmonary functions,

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Lazarus JM. Hakim RM: Medical aspects of hemodialysis. In: The kidney (vol 2) edited by Brenner BM, Rector FC: Philadilphia, WB Saunders, 2223-2298, 1991.
Becklake M, Crapo RO, Buist S : Lung function testing: Selection of reference values and interpretative strategies. An offîcial statement of the American Thoracic Society. AmRevRespirDis 144:1202-1218,1991.
CrapoRO, GardnerRM, Clausen JL: Singlebreath carbon monoxide capacity (transfer factor): Recommendations for a Standard technique. Am Rev Respir Dis 136:1299-1307,1987.
Wanger J. Pulmonaıy Function Testing: APractical Approach. USA, Williams-Williams, 118,1992.
CrapoRO, Morris AH, GardnerRM: Reference spirometric values using techniques and equipment that meet ATSrecommendations. AmRevRespirDis, 123:659- 64.1981.
Crapo RO, Morris AH: Standardized singlebreath normal values for carbon monoxide diffiısing capacity. Am Rev Respir Dis, 123:185-9,1981.
Bush A, Gabriel R.: Pulmonaıy function inchronic renal failure: Effects of dialysis and transplantation. Thorax 46:424-428,1991.
Dujic Z, Tocilj J, Ljutic D, Eterovic D: Efifect of hemodialysis and anemia on pulmonary diffiısing capacity, membrane diffiısing capacity and capillar blood volüme in uremic patients, Respiration 58:277-281,1991.
Macdougall IC, Lewis NP, Sounders MJ: Long- term cardiorespirotory effects of amelioration of renal anaemiaby erythropoietin. Lancet 335: 489-493,1990.
Moinard J, GuenardH: Membrane diffusion of the lungs in patients with chronic renal failure. Eur Respir J 6:225-230,1993.
BarkH, Heimer D, Chaimovitz C, Mostoslovski M: Effect of chronic renal failure on respiratory muscle. Respiration54: 153-161,1988.
Paul K, Mavridis G, Bonzel KE, Scharer K: Pulmonary function in children with chronic renal failure. Eur JPediatr 150:808-812,1991.
Wanic-Kossowska M: Effect of peritoneal dialysis and hemodialysis on respiratory function in patients with chronic renal failure. Pol Arch Med Wewn 85: 303- 311,1991.